title: Role of the aromatase inhibitor letrozole in the management of uterine leiomyomas in premenopausal women.
abstract: BACKGROUND
  Uterine myomas are benign tumours affecting 20-40% women. Various medical and surgical therapeutic options are available but the search for an ideal medical option continues. Aromatase inhibitors have recently been reported to have a potential role in the management of oestrogen-dependent conditions like endometriosis and leiomyoma.
  
  
  OBJECTIVE
  To evaluate the effect of letrozole on uterine myoma size and symptomatology in perimenopausal women.
  
  
  METHODS
  Prospective interventional study conducted on 30 premenopausal women aged between 30 and 55 years with menstrual or pressure symptoms and having a single intrauterine myoma of size 4 cm or more with or without one or more additional myomata each of size 2 cm or less. They received tablet letrozole 2.5 mg a day for 12 weeks, and the effect of the drug on myoma size and volume and symptomatology was studied along with the adverse effect profile and patient satisfaction.
  
  
  RESULTS
  The mean myoma size reduced from 5.4±1.3 cm to 4.3±0.9 cm (p<0.05) and the myoma volume exhibited a reduction of 52.45% (p=0.00) at the end of 3 months. The symptomatology score showed a significant improvement that persisted up to 3 months after cessation of therapy. No significant effect was observed on lipid profile, serum estradiol, progesterone, testosterone and FSH and LH levels during the therapy. Nausea and hot flushes were the main adverse effects observed and were self-limiting.
  
  
  CONCLUSIONS
  Letrozole significantly reduces myoma size and volume and also improves the associated symptoms. It has a good adverse effect profile and appears to be a promising medical option for management of uterine myomas.
authors.affiliation: Department of Obstetrics & Gynecology, Pt. B.D. Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India. Electronic address: nkadian@gmail.com.
authors.forename: Nirmala
authors.initials: N
authors.lastname: Duhan
authors.forename: Shikha
authors.initials: S
authors.lastname: Madaan
authors.forename: Jyotsna
authors.initials: J
authors.lastname: Sen
mesh_terms: D000328:Adult; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000188:drug therapy* / Q000473:pathology; D000077289:Letrozole; D008875:Middle Aged; D009570:Nitriles / Q000627:therapeutic use*; D017697:Premenopause; D011446:Prospective Studies; D014230:Triazoles / Q000627:therapeutic use*; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D047072:Aromatase Inhibitors; D009570:Nitriles; D014230:Triazoles; D000077289:Letrozole
keywords: Letrozole; Medical therapy; Uterine myoma